Scott Willis, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

997 Issued in SC

Practice address

2105 Cromley Cir Ste B
Myrtle Beach, SC 29577-3168

Phone

(843) 626-6666

Fax

(888) 456-9396

NPI assigned

Feb 17, 2011

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Surfside SW LLC

  • General Practice Dentistry
  • Surfside Beach, SC
  • NPI 1851115810
  NPD Authorized official
• Willis Chiro Med-MB, Inc.

  • Chiropractor
  • Myrtle Beach, SC
  • NPI 1235436619
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1297900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300665600000",
    "number": "1982901567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 CROMLEY CIR STE B",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295773168",
            "telephone_number": "843-626-6666",
            "fax_number": "888-456-9396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 CROMLEY CIR STE B",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295773168",
            "telephone_number": "843-626-6666",
            "fax_number": "888-456-9396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "SCOTT",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-17",
        "last_updated": "2011-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PRACTICE NPI",
            "identifier": "1235436619",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "285258",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "5316",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roddy Williams
• Ryan Neal Williams, OD
• Todd E Williams, M.D.
• Virginia Caroline Williams, MD
• Willis Chiro Med-MB, Inc.
• Denise Wilson, RN-CDE
• Jacquelyne Jones Wilson, MA, LPC
• Lisa Marie Wilson, PA
• Shaliah Deaisja Monteia Wilson
• Charlotte Wiltshire, RDN

• Chiropractor in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Chiropractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.